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Low lean mass with obesity in older adults with hypertension: prevalence and association with mortality rate
BACKGROUND: The influence of sarcopenic obesity (SO) on overall survival in older adults with hypertension has not been addressed. The aim of this study was to investigate the prevalence and mortality predictive value of various body composition phenotypes, focusing mainly on SO, in older adults wit...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10546679/ https://www.ncbi.nlm.nih.gov/pubmed/37789259 http://dx.doi.org/10.1186/s12877-023-04326-x |
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author | Qu, Qiang Guo, Qixin Sun, Jinyu Lu, Xinyi Cheang, Iokfai Zhu, Xu Yao, Wenming Li, Xinli Zhang, Haifeng Zhou, Yanli Liao, Shengen Gao, Rongrong |
author_facet | Qu, Qiang Guo, Qixin Sun, Jinyu Lu, Xinyi Cheang, Iokfai Zhu, Xu Yao, Wenming Li, Xinli Zhang, Haifeng Zhou, Yanli Liao, Shengen Gao, Rongrong |
author_sort | Qu, Qiang |
collection | PubMed |
description | BACKGROUND: The influence of sarcopenic obesity (SO) on overall survival in older adults with hypertension has not been addressed. The aim of this study was to investigate the prevalence and mortality predictive value of various body composition phenotypes, focusing mainly on SO, in older adults with hypertension. METHODS: We included 1105 hypertensive patients aged ≥ 60 years from the National Health and Nutrition Examination Survey 1999–2004. Sarcopenia was broadly defined based on low lean mass (LLM; as measured by dual-energy X-ray absorptiometry), and was defined using appendicular lean mass (ALM) divided by height squared (ALM/height(2)), weight (ALM/weight), and body mass index (BMI; ALM/BMI), respectively. Obesity was defined as BMI ≥ 30 kg/m(2), body fat percentage ≥ 30/42%, or waist circumference ≥ 102/88 cm. The prevalence of LLM with obesity was estimated according to each ALM index (ALMI). Multivariable Cox regression analysis and sensitivity analysis were used to examine the association between various body composition phenotypes and all-cause mortality. RESULTS: In older adults with hypertension, the prevalence of LLM with obesity by the ALM/height(2) index (9.8%) was lower relative to the ALM/weight (11.7%) and ALM/BMI indexes (19.6%). After a median follow-up of 15.4 years, 642 deaths occurred. In the fully adjusted models, LLM with obesity was significantly associated with a higher risk of all-cause mortality (hazard ratio [HR] 1.69, 95% confidence interval [CI] 1.14–2.49, P = 0.008; HR 1.48, 95% CI 1.04–2.10, P = 0.028; HR 1.30, 95% CI 1.02–1.66, P = 0.037; respectively) compared with the normal body phenotype, with no statistical differences found in individuals with LLM or obesity alone. Sensitivity analysis confirmed the robustness of the results. CONCLUSIONS: The prevalence of LLM with obesity markedly differed in older adults with hypertension according to the 3 different ALMIs, varying from 9.8%, 11.7%, to 19.6%. Patients with both LLM and obesity had a higher risk of all-cause mortality. Further large, prospective, cohort studies are warranted to validate these findings and uncover underlying mechanisms. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-023-04326-x. |
format | Online Article Text |
id | pubmed-10546679 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-105466792023-10-04 Low lean mass with obesity in older adults with hypertension: prevalence and association with mortality rate Qu, Qiang Guo, Qixin Sun, Jinyu Lu, Xinyi Cheang, Iokfai Zhu, Xu Yao, Wenming Li, Xinli Zhang, Haifeng Zhou, Yanli Liao, Shengen Gao, Rongrong BMC Geriatr Research BACKGROUND: The influence of sarcopenic obesity (SO) on overall survival in older adults with hypertension has not been addressed. The aim of this study was to investigate the prevalence and mortality predictive value of various body composition phenotypes, focusing mainly on SO, in older adults with hypertension. METHODS: We included 1105 hypertensive patients aged ≥ 60 years from the National Health and Nutrition Examination Survey 1999–2004. Sarcopenia was broadly defined based on low lean mass (LLM; as measured by dual-energy X-ray absorptiometry), and was defined using appendicular lean mass (ALM) divided by height squared (ALM/height(2)), weight (ALM/weight), and body mass index (BMI; ALM/BMI), respectively. Obesity was defined as BMI ≥ 30 kg/m(2), body fat percentage ≥ 30/42%, or waist circumference ≥ 102/88 cm. The prevalence of LLM with obesity was estimated according to each ALM index (ALMI). Multivariable Cox regression analysis and sensitivity analysis were used to examine the association between various body composition phenotypes and all-cause mortality. RESULTS: In older adults with hypertension, the prevalence of LLM with obesity by the ALM/height(2) index (9.8%) was lower relative to the ALM/weight (11.7%) and ALM/BMI indexes (19.6%). After a median follow-up of 15.4 years, 642 deaths occurred. In the fully adjusted models, LLM with obesity was significantly associated with a higher risk of all-cause mortality (hazard ratio [HR] 1.69, 95% confidence interval [CI] 1.14–2.49, P = 0.008; HR 1.48, 95% CI 1.04–2.10, P = 0.028; HR 1.30, 95% CI 1.02–1.66, P = 0.037; respectively) compared with the normal body phenotype, with no statistical differences found in individuals with LLM or obesity alone. Sensitivity analysis confirmed the robustness of the results. CONCLUSIONS: The prevalence of LLM with obesity markedly differed in older adults with hypertension according to the 3 different ALMIs, varying from 9.8%, 11.7%, to 19.6%. Patients with both LLM and obesity had a higher risk of all-cause mortality. Further large, prospective, cohort studies are warranted to validate these findings and uncover underlying mechanisms. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-023-04326-x. BioMed Central 2023-10-03 /pmc/articles/PMC10546679/ /pubmed/37789259 http://dx.doi.org/10.1186/s12877-023-04326-x Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Qu, Qiang Guo, Qixin Sun, Jinyu Lu, Xinyi Cheang, Iokfai Zhu, Xu Yao, Wenming Li, Xinli Zhang, Haifeng Zhou, Yanli Liao, Shengen Gao, Rongrong Low lean mass with obesity in older adults with hypertension: prevalence and association with mortality rate |
title | Low lean mass with obesity in older adults with hypertension: prevalence and association with mortality rate |
title_full | Low lean mass with obesity in older adults with hypertension: prevalence and association with mortality rate |
title_fullStr | Low lean mass with obesity in older adults with hypertension: prevalence and association with mortality rate |
title_full_unstemmed | Low lean mass with obesity in older adults with hypertension: prevalence and association with mortality rate |
title_short | Low lean mass with obesity in older adults with hypertension: prevalence and association with mortality rate |
title_sort | low lean mass with obesity in older adults with hypertension: prevalence and association with mortality rate |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10546679/ https://www.ncbi.nlm.nih.gov/pubmed/37789259 http://dx.doi.org/10.1186/s12877-023-04326-x |
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